Binder Nicholas R, Kruglyakova Jacqueline, Borchert Mark S
Keck School of Medicine, University of Southern California, Los Angeles, California; The Vision Center, Children's Hospital Los Angeles, California; Quantum Vision Centers, Belleville, Illinois.
Department of Biological Sciences, University of Southern California, Los Angeles, California.
J AAPOS. 2016 Apr;20(2):121-5. doi: 10.1016/j.jaapos.2015.12.010.
To investigate the rate of spontaneous resolution of strabismus in patients with cortical visual impairment (CVI) at a single center over a 10-year period and to evaluate the success rate of strabismus surgery.
The medical records of patients with CVI and strabismus seen between October 2003 and October 2013 were reviewed retrospectively. Patients were classified into 4 outcome groups: (1) those who experienced spontaneous resolution of strabismus, (2) those with persistent strabismus who did not undergo surgery, (3) those who achieved postoperative alignment of ≤10(Δ); and (4) those whose final postoperative alignment was 11(Δ)-25(Δ) or >25(Δ).
A total of 70 patients were included. Of these, 11 patients (16%) experienced spontaneous resolution of strabismus, 27 (38%) were observed without receiving surgery, and 32 (46%) underwent strabismus surgery. Of these 32, 18 (56%) achieved alignment of ≤10(Δ); 9 (28%), alignment of 11(Δ)-25(Δ); and 5 (16%), alignment >25(Δ). The patients who did not undergo surgery were significantly older at presentation (36 months vs 12-15 months; P = 0.03); otherwise, there were no significant differences between groups in age at surgery or spontaneous resolution, type of strabismus, or underlying cause of CVI.
In our study cohort, a minority of patients with CVI and strabismus (16%) experienced spontaneous resolution of strabismus. Only 16% of patients undergoing surgery had poor final alignment (>25(Δ)). Strabismus surgery can be reasonably successful in properly selected patients with CVI and strabismus. These patients show considerable rates of resolution of their strabismus, either spontaneously or through surgery.
调查在一个单一中心10年期间皮质视觉障碍（CVI）患者斜视的自然缓解率，并评估斜视手术的成功率。
回顾性分析2003年10月至2013年10月期间就诊的CVI合并斜视患者的病历。患者被分为4个结局组：（1）斜视自然缓解的患者；（2）未接受手术的持续性斜视患者；（3）术后眼位偏差≤10（Δ）的患者；（4）术后最终眼位偏差为11（Δ）-25（Δ）或>25（Δ）的患者。
共纳入70例患者。其中，11例（16%）斜视自然缓解，27例（38%）未接受手术观察，32例（46%）接受了斜视手术。在这32例患者中，18例（56%）眼位偏差≤10（Δ）；9例（28%），眼位偏差为11（Δ）-25（Δ）；5例（16%），眼位偏差>25（Δ）。未接受手术的患者就诊时年龄显著较大（36个月 vs 12 - 15个月；P = 0.03）；否则，各手术组或自然缓解组在手术年龄、斜视类型或CVI潜在病因方面无显著差异。
在我们的研究队列中，少数CVI合并斜视患者（16%）斜视自然缓解。仅16%接受手术的患者最终眼位偏差较差（>25（Δ））。对于经过适当选择的CVI合并斜视患者，斜视手术可取得合理成功。这些患者的斜视无论是自然缓解还是通过手术缓解的比例都相当可观。
